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gardenlady

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gardenlady

I'm down to 27.7 mg from 60 mg and am feeling very irritable, angry and negative....more so than ever before.  I'm also very depressed and think about death a lot.   I wonder if it will be this way the rest of the way down.  It would be nice to hear from others who have traveled this road.  I have so very far to go and at this rate, it will take more than a year to be finished....possibly more. 

 

I'm cutting by 2.5% weekly which amounts to 10% monthly weighing the beads on a gram scale. 

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ChessieCat
2 hours ago, gardenlady said:

am feeling very irritable, angry and negative....more so than ever before.  I'm also very depressed and think about death a lot.

 

What I'm writing isn't to make you feel bad and I'm sorry that it is not positive but it might help you to know that someone else is struggling and questioning things.

 

I've been feeling very negative recently and thinking about death as well.  I'm about to turn 61, and starting to get arthritis in my hands and knees and other aches, pains and stiffness.  I can only get voluntary work (15 hours over 3 days per week) which I am required to do to get government benefits (for which I am very thankful)  However the benefits I get don't quite cover my outgoing $$$ so in the next few years I am going to have to sell my house to gain access to money.  The voluntary work I can get is very limited because my skills are as an admin assistant which are usually paid roles.  The house I live in hasn't been maintained as my husband had his own business and we lived week to week.  It's hard for me to know if how I am feeling is made worse by the tapering, and I've recently been wondering if it would be better to stay on an AD so that my feeling are numbed a bit by the drug.

 

I know when I turned 60 last year I realised that I've lived at least 2/3rds of my life.  I've been widowed for 20 years and am not interested in getting married again, but I find it very lonely.

 

So my question to you is, could some of what you are going through be related to the stage of life you are at?

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gardenlady

CC, Thanks for responding.  I'm so very sorry about all that you've been struggling with since the death of your husband.  And to have AD withdrawal on top of it makes it all more difficult.  

 

Did we connect on the Finding Meaning thread?  I seem to recall that you are a believer in Christ and that we exchanged some posts a year or so ago.  I bring it up because I think that my core problem is unbelief.....knowing the truth, but not trusting....and I'm still trying to understand why it's so hard for me.  I don't have intellectual issues with Christ, it's just a difficulty in trusting Someone Whom I don't know.  I keep telling myself that all I need to know about Jesus is in the Bible and if I would simply trust Him, then my spiritual torment would end.  I think I've been deceiving myself thinking that the AD withdrawal was my problem, but it's much deeper and older than that.  Of course, it distorts my thinking and makes everything seem worse than it is, but my spiritual alienation from God predates ADs, so I have to stop blaming it on that.

 

I do think that my age (65) coupled with the spiritual unrest is the main problem, as you suggested.  Cymbalta withdrawal just makes it all worse.  Do you have any counsel for how to simply start trusting Christ at this late age and in the middle of Cymbalta depression?   I keep asking the Lord to help me trust and believe as He is the Author of faith. 

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ChessieCat

Yes we have chatted in another topic.  I will send you a PM later.

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sadandconfused
On 9/25/2018 at 1:30 PM, gardenlady said:

Has anyone else had a total personality change for the worse when tapering an AD?  I'm wondering how to survive this as I have another 1+ year of tapering and then the recovery after that.  I have lost my family and friends because of it.  I've turned into someone I've never known before and am sorry I've met her. 

 

Hi, 

first off I'm so sorry you're going through this agony. Im going through almost the exact same thing. I was a very happy person and my main symptom was social anxiety. In August 2015 I was put on 10 mg of Lexapro and I did not feel any different on it whatsoever, I didn't even think it helped my anxiety to be honest, but a month and a half after quitting cold turkey I became a COMPLETELY different person. I do not care about anything I once did, I have horrible thoughts, there is nothing that can make me happy. I know this is normal in withdrawal but it's the scariest thing I've ever gone through and the uncertainty on not knowing if and we've you'll become yourself again is torture. 

I really hope things start getting better for you soon

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gardenlady

Sad, Thank you for your kind response.  I am terribly sorry for what you are going through as I can relate, unfortunately.  Did your reinstatement help at all?  I do wonder if our personalities will ever come back or if they are permanently damaged.  You're right, it's torture.

 

My heart goes out to you and I hope both of us will get at least a glimpse of improvement soon.  

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nick1990

Hi Garden Lady. I haven’t been following your thread but after reading your post about how your feeling I want to give my 2 cents..

 

you say your tapering 2.5% a week for 4 weeks . That’s 10% a month - which is the MAXIMUM taper speed recommended by SA. You may have milder symptoms doing the BrassMonkey slide method than if you did a straight 10% drop, however your still doing a total 10% drop . Many, many people here find that 10% a month is too harsh on their nervous systems. I’m having a little break from tapering for several weeks, but have been successfully reducing my dosage anywhere from 4% to 6% a month . Doing a 1.5% drop at a time . If I feel symptoms are getting a little uncomfortable, I slow down and hold for an extra week or two until I’m feeling ok to resume . It may be slower, but in the last 18 months I’ve reduced nearly to 20mg from 45mg citalopram. Not only that, but I’ve had a really good year. My thinking has been clearer and my mood has improved. I’ve been finding myself more passionate about things and feeling my true self returning as I reduce the amount of drug from my body. Waves still come and go but they are very manageable for the most part and I return to feeling ok soon after . 

 

Im telling you this in the hope that it may help you . I really am a huge advocate for slow tapering and listening to your body , as apposed to a schedule . 

 

If you do this faster than your CNS can handle , you will pay the price - and as you know , it can be very painful emotionally and physically. 

 

Be well and look into slow tapering .

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gardenlady

Thanks, nick1990.  Yes, I'm aware that I'm tapering the equivalent of 10% per month.  But that's because regardless of how long I hold or how slowly I go, I have nearly the same symptoms, so I don't want to drag it out any longer than necessary.  I haven't had a clear mind since I started taking Cymbalta...it has messed me up beyond anything I could have imagined.  I probably have another 2 years of tapering ahead of me and then years of healing afterwards.  I'm 65, so time is running out.  I really do appreciate your post, though.  Will you remind me of what brassmonkey's slide method is?

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Gridley

The Brassmonkey slide is a drop of 2 1/2% of current dose for four weeks, then a 2-week hold before the next taper to let your system adjust to the lower dosage.  It's the method I'm using with my Lexapro taper.  Here's a link:

Edited by ChessieCat
fixed link

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sadandconfused

Gardenlady,

Thank you so much. My reinstatement definitely did help at the time. I was 8 months into cold turkey and I had a complete breakdown, I was crying all the time, could not even pretend to be happy around my boyfriend or family, I felt like I was waking up in a nightmare everyday. I didn't know much about reinstatement so I reinstated way too high or a dose instead of 1mg like they recommend on here so I wonder now if that slowed down my healing at all. 

 

Thank you! I really hope both of us heal soon and start to get pieces of ourselves back 

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WantoffVen

Hi Gardenlady, I too am age 65 and yes my age is bothering me. I'm not accepting getting older graciously. But I am a believer and I understand why God seems far away sometimes during this process. Remember this is there anything we are going through worse than what Christ went through on his journey to and on the cross. I think not. And he did it for the love of all mankind and I can't even love everyone in my family at times. So I'll leave you with this thought "I can do all things through Christ who strengthens me." I'm here anytime you wanna talk.

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gardenlady

Thanks, gridley, for sending brassmonkey's slide rule link!  That's sort of what I've been doing, just not as regular with the 2 week holds in between the 4 consecutive 2.5% drops.  But I do it when it gets too hard to handle.

 

wantoffven, Thanks for your kind post!  I am having the most troubling time, spiritually, and was heartened to read your post.  Thank you for reminding me that what Christ suffered for us is far greater than anything we could imagine....and more so than anything we will face.  I just feel so distant from Him and having rebellious thoughts that scare me.  I hope it's the drug, but how in the world can one know?  

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WantoffVen

If you thoughts were rebellious you wouldn't be thinking about them. We can go through what Catholics call "the dark night of the soul" and this is when we feel God isn't there and it happens to everyone. I wonder sometimes if I'll get off my A/D and benzo before I die but then I think well "by golly I'll die trying anyway". lol  Having found this site has given me a whole new bunch of people to pray for. I noticed you live in Memphis. We are in central IL and are considering eastern TN to retire to. Any thoughts? 

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gardenlady

Thanks, Want.  No, unfortunately I don't know much about East Tennessee. 

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gardenlady

I am holding at 25 mg Cymbalta and having a very, very rough time.  I was cutting at 2.5% per week with holds every few weeks but am now holding indefinitely as I'm non-functional.  The black depression, fear, dread, doom and obsessive/compulsive thoughts are incapacitating.  I am completely isolated because of personality disintegration and inability to relate to anyone.  The longstanding anhedonia prevents me from experiencing any joy or pleasure in anyone or anything.  Going for a walk is a drudge and I come back more depressed.  

 

With possibly 3 years or more of tapering ahead of me followed by years of recovery, I'm overwhelmed and finding it difficult to have hope.  I don't see how I can live as an agoraphobic recluse for the next several years.  At 66 years of age, I don't have much time left.  

 

I'm sorry to be so negative, but that's where I am.  How do people get though this feeling this way for so many years?  

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WantoffVen

Hi Gardenlady,

 

Don't know if you remember me but I'm also 65. I'm weaning off Venlafaxine and then I'll have to tackle Diazepam. I was thinking the other day I might be dead before I get off these meds or at least I'll die trying and I laughed a bit. I'm not a mod but I was wondering if you felt any better at a slightly higher dosage. Hopefully one will come along soon and advise. Have you had no windows? I made a small updose a few weeks ago and it helped. Now I'm coming down 2.5% a week. Now I'm still on Diazepam so I don't know if that is helping. Right now I'm feeling stressed because I have a UTI and I've been on an antibiotic almost a week and it's not gotten better and I know my doctor will want me to try Levaquin next which he would have put me on to begin with but I didn't go to him. On an antibiotic side note Levaquin is a nasty one but effective if you don't get side effects. Well enough about me. Let's pray for one another. 

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gardenlady

Thanks, Want.  I'm sorry you're suffering so much and with a UTI on top of it.  You're fortunate you have a husband who can help you.

 

I've felt poisoned ever since a psychiatrist crossed me from Lexapro to Cymbalta over 2 years ago....I was in benzo withdrawal which she didn't believe in and thought another AD would make me feel better.  It made everything worse.  So, no, there isn't a dose I've felt stable on as I've been sick ever since taking it.  I'd cold-turkey it if I thought I could survive it, but as I'm alone, I don't think I would so am forced to keep on with this tortuous taper.  

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WantoffVen

Hi Gardenlady,

 

Wow I am so sorry. Honestly I have been on ADs for years and years and have changed a few times and never had any long lasting problems. So far with my Venlafaxine withdrawal it's not been bad although I fear going to lower doses. I feel so badly for you that's it been lousy the whole time. My husband works all the time. I want him to retire!!!!!!!! I hope I can get him to by spring of next year. But yes he is a little bit of help. I will pray for you.

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gardenlady

Thanks, Want.  I really do appreciate it.  

 

I'm not sure there's anything the moderators can suggest that would help, but perhaps I'm wrong.  Sure hope so!  Perhaps one of them will chime in. 

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WantoffVen

Well they never say speed up your taper. I don't think I've ever seen that. I was wondering if you are miserable and have been since you went on Cymbalta what if you did taper faster. Could it get worse? I suppose it could. Hope one of the mods stops by soon. God Bless

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Songbird
8 hours ago, gardenlady said:

I'm not sure there's anything the moderators can suggest that would help, but perhaps I'm wrong.  Sure hope so!  Perhaps one of them will chime in. 

 

You're in a difficult situation since the Cymbalta has never agreed with you, so it's possible that you may never truly stabilise on it, but even so it needs to be tapered slowly so that your system can adjust.  If you've been feeling a lot worse lately, it may be that your system is trying to catch up with previous dose drops.  You might consider holding for a while, and then tapering more slowly after that.  A lot of people find tapering more difficult as dose gets lower.  This topic explains one theory as to why this happens:

 

Why-taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

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gardenlady

Thanks, Songbird.  Yes, I'm holding, but am in a very bad way.  Feeling like there's on point in going on.  

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WantoffVen

Gardenlady,

I'm so sorry you are feeling so badly. A lot of things like the holidays coming now that might be underlying reason you are feeling worse. And winter. Don't know how bad winter gets in Memphis. I prayed for you this morning. Remember there's someone in Illinois who wants you to go on if that means anything to you. God bless.

 

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Songbird
8 hours ago, gardenlady said:

Yes, I'm holding, but am in a very bad way.  Feeling like there's on point in going on.  

 

I'm sorry to hear you're having such a rough time.  Many of us here have felt that way at times.  There's always a point to going on, but sometimes we have to take things one day at a time, or one hour at a time, or one minute at a time, to get through.  Instead of being concerned about the future, focus on the present moment.  Waves pass eventually.

 

You might find it helpful to talk to a professional counsellor, or call a helpline if you need to.  Have a read of this topic:  For those who are feeling desperate or suicidal

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gardenlady

From an equivalency chart, 20 mg of Prozac equals 30 mg of Cymbalta.  So, if I'm on 25 mg of Cymbalta and want to bridge to Prozac, is 10 mg of Prozac too little?  My doctor gave me 10 mg Prozac capsules and told me to take it for a week and then cut the Cymbalta.  I'm scared since even 2.5% cuts of Cymbalta are brutal.  I'm afraid I'll get psychotic & suicidal when eliminating the Cymbalta and that the Prozac won't be sufficient to withstand the withdrawals.  I live alone and have absolutely no one whom I can call or who can help me.  How can I attempt to bridge in this situation? 

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Songbird
6 hours ago, gardenlady said:

From an equivalency chart, 20 mg of Prozac equals 30 mg of Cymbalta.  So, if I'm on 25 mg of Cymbalta and want to bridge to Prozac, is 10 mg of Prozac too little?  My doctor gave me 10 mg Prozac capsules and told me to take it for a week and then cut the Cymbalta.  I'm scared since even 2.5% cuts of Cymbalta are brutal.  I'm afraid I'll get psychotic & suicidal when eliminating the Cymbalta and that the Prozac won't be sufficient to withstand the withdrawals.  I live alone and have absolutely no one whom I can call or who can help me.  How can I attempt to bridge in this situation? 

 

I think 10mg Prozac is roughly equivalent to about 30mg of Cymbalta, so this seems a reasonable dose for the bridge.

Before you start, please read these topics thoroughly for information about bridging from duloxetine to fluoxetine:

 

Tips for tapering off Cymbalta/duloxetine

The Prozac switch or bridging with Prozac

 

 

 

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ChessieCat
17 hours ago, gardenlady said:

From an equivalency chart, 20 mg of Prozac equals 30 mg of Cymbalta.  So, if I'm on 25 mg of Cymbalta and want to bridge to Prozac, is 10 mg of Prozac too little?

 

BrassMonkey (on holidays at the moment) dropped in about 3 hours ago and mentioned that he thinks that the dose is too low.

 

"Using the numbers she quoted an equal dose would by 17mgai prozac.  So switching to 10mgai would not be enough."

 

mgai = mg active ingredient (the dose)

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gardenlady

Thanks, CC.  Alto seems to instruct people to use very small doses of an AD when reinstating....does this apply to bridging, too?  Awhile back when I broached the subject of bridging, she didn't comment that the 10 mg Prozac dose was too low.  I'm getting conflicting messages, but perhaps I'm misunderstanding.  Could the mods clarify what dose I should use if and when I bridge?  I cut to 24 mg Cymbalta today. 

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Gridley

Bridging is totally different from reinstating.  If/when you bridge, you should bridge with an equivalent amount to whatever your current dose of Cymbalta is.  Brassmonkey is a math whiz, so I would trust his figures.

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ChessieCat

The way I calculated it to check BrassMonkey's figures:

 

20 mg of Prozac equals 30 mg of Cymbalta

 

        20 : 30

 

   3.333 : 5     divide both sides by 6

 

16.666 : 25   multiply both sides by 5

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Altostrata

What equivalency chart?

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Altostrata

Those people must be guessing. I can't find any substantiation of that equivalence between fluoxetine and duloxetine. None of the studies available have included duloxetine.

 

As Cymbalta is an SNRI and Prozac is an SSRI, you run the risk of serotonin syndrome, as their effects on serotonin can be additive. This makes it tricky to switch from Cymbalta to Prozac.

 

Guides like this one advise tapering off the SNRI first, then adding the fluoxetine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919171/

 

This guy advises a cold switch http://wiki.psychiatrienet.nl/index.php/Duloxetine-fluoxetine

 

This guide is adapted from the Maudsley (UK) guidelines and advises a cautious cross-taper with low-dose fluoxetine:

https://ww2.health.wa.gov.au/~/media/Files/Corporate/general documents/WATAG/WAPDC/Antidepressant-switching-strategies-March-2013.pdf

 

Here's a Canadian doctors' article also advising a cross-taper that looks like it has the same sources http://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/depress_appd.pdf

 

The article recommends this informative Web site for switching psychiatric drugs https://www.switchrx.ca/ For a switch of 30mg duloxetine to fluoxetine, it recommends a cross-taper:


18_crosstaper_duloxetine_fluoxetine.png

 

As you are accustomed to a dosage of 30mg Cymbalta, one cross-taper approach might be to take 20mg Cymbalta with 5mg Prozac, wait 3 days for the Prozac to take effect, then cut the Cymbalta dosage to 10mg while adding 5mg Prozac. Take the 10mg Cymbalta with 10mg Prozac for 3 days, then drop the Cymbalta altogether.

 

This accomplishes the switch within a week.

 

As you can see, you may suffer some symptoms from the drug switch. It's possible you'll get withdrawal when you reduce your Cymbalta intake to 20mg, before the Prozac takes effect. It's possible Prozac at any dosage level will not adequately substitute for Cymbala. To reduce the risk of serotonin syndrome, you need to be careful not to take too much Prozac.

 

It would be best if you did this with the guidance of a doctor.

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Altostrata

Of course, you've also read this carefully from Tips for tapering off Cymbalta (duloxetine)

 

On 5/6/2011 at 12:26 PM, Altostrata said:

Like its fellow SNRI Effexor, withdrawal from Cymbalta can be very difficult. Recently, I asked a knowledgeable doctor about how he switches patients to Prozac.

He said if the dosage of Cymbalta is "normal" -- 30mg-40mg -- he would switch to 10mg Prozac with a week of overlap. In other words, take both medications for a week and then drop the Cymbalta.

Later, taper off Prozac. He acknowledged Prozac can have its withdrawal problems, but given Prozac's long half-life, gradual tapering should be much easier than tapering off Cymbalta. And, at least Prozac comes in a liquid.

He confirmed that Cymbalta cannot be compounded because the pellets are enteric-coated to get the medication past the stomach acid, which destroys it. Other than the Prozac switch, he said counting pellets is the only way to taper.
 
See more about the Prozac switch http://survivingantidepressants.org/index.php?/topic/1463-the-prozac-switch-or-bridging-with-prozac/

 

Still, it would be best if you did this under a doctor's supervision.

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gardenlady

Thanks, Alto.  I'm down to 24 mg of Cymbalta as of today.  I'm tapering under a doctor's so-called supervision and he told me to take 10 mg of Prozac for a week and then drop the Cymbalta.  He's clueless about psych drug withdrawal.  His first advice was to get off the Cymbalta by taking 30 mg every other day for a week and then dropping it.  When I objected, he came up with the Prozac idea.

 

He knows nothing, nor do any of the other doctors I've seen, which is why I'm on this site.  He condescendingly told me he'd never heard of anyone counting Cymbalta beads as I am and looked at me like I was crazy.  I have to do this on my own as I can't find a doctor who is intelligent about it. 

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Altostrata

It sounds to me like a cross-taper with Prozac is doable with the help of 20mg Cymbalta capsules. You'll want liquid Prozac.

 

You might ask around among your local psychiatrists and see if any of them know how to cross-taper.

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